COVID-19 Death Rates Far Higher in SNFs Than Most Other Senior Living Facility Types, Analysis Finds

A new analysis of independent living, assisted living, memory care and skilled nursing facilities across dozens of counties in select states found that 39% of SNFs had no COVID-19-related deaths during 2020.

The analysis was conducted by NORC at the University of Chicago through a grant provided by the National Investment Center for Seniors Housing & Care (NIC). It drew data from more than 100 counties across five states, Colorado, Connecticut, Florida, Georgia and Pennsylvania.

Those states had the data necessary to support the analysis when it began in September 2020, the report noted. While the geographies have some variation in demographics, pandemic timing and other factors, they are not representative of the U.S. as a whole.

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The analysis used data from the COVID-19 Nursing Home Dataset maintained by the Centers for Medicare & Medicaid Services (CMS); NIC MAP data from NIC affiliate NIC Map Vision; publicly available state reports of deaths in senior housing settings, as well as by county and age group; American Community Survey data on population; and data on COVID-19 cases reported by The New York Times.

Generally, the analysis used CMS data to estimate deaths in SNFs, according to the technical report. It selected all properties with SNF beds in each of the five states, with 2,029 beds and an estimated 242,185 residents included. The analysis found a total of 14,574 deaths in skilled nursing across 113 counties.

Across all senior housing property types, 51% of facilities had no reported COVID-19 deaths in 2020. For SNF properties, 39% had no reported COVID-19 deaths.

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Source: NORC at the University of Chicago

Deaths from COVID-19 across senior housing types increased with the level of care provided in each, the analysis noted, with the mortality rate of assisted living facilities one-third that of SNFs. Specifically, SNFs saw an adjusted COVID-19 mortality rate of 59.6 deaths per 1,000 residents, compared with 50.4 deaths per 1,000 residents in memory care and 19.3 deaths per 1,000 residents in assisted living.

*The mortality rates in skilled nursing and memory care are considered statistically equivalent to each other, the report noted.

“Prior to COVID-19, almost one-third of all skilled nursing care residents died annually, with that particular setting of care often being the final long-term residence for seniors prior to their death,” the report said. “While COVID-19 likely increased overall mortality rates across all seniors housing segments, its total impact on all-cause mortality in these settings is not yet known.”

*An earlier version of this story said in the headline that COVID-19 death rates in SNFs exceeded other senior living facility settings; the death rates for SNFs and memory care were statistically equivalent, according to the report. SNN regrets the error.

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